Basha Ontiveros, M.S., CCC-SLP
NPI #1629083423 in Bloomington, Illinois
Provider Information
- NPI Number
- 1629083423
- Entity Type
- Individual
- Name
- Basha Ontiveros, M.S., CCC-SLP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- M.S., CCC-SLP
- Enumeration Date
- Jul 30, 2006
- Last Updated
- Aug 22, 2022
Practice Location
- Address
- 2416 E WASHINGTON ST STE C5
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-1629
- Phone
- (913) 730-5925
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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